I mean the next more complicated case isn't that bad either. You set up a sidecar VM/container/machine/whatever-you-want that either instruments your DNS or gets the traffic from .well-known/acme-challenge and just renews your certs every day.

Then your load balancers pull the current cert from the sidecar every day with NFS/Gluster/Ceph/HTTP/whatver-you-want and reload the web server if it changed.

Assuming that you can catch a failure of your sidecar server in 89 days or so you don't need much more redundancy.